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Mid Staffs failures: who is to blame?

I think that the general consensus is no one. I believe 40 doctors were brought before the general medical council but not one was censured same sort of thing with nursing regulatory bodies and obviously no one within the management structure is ever at fault, or rather not enough at fault to take responsibility.

So we have appalling care,appalling management resulting in many unnecessary deaths yet I have heard very few apologies from those directly involved or responsible, in fact I believe promotions and pay rises or retiring rather quickly with a handsome payout are the order of the day.

As with banks there seems to be a point where responsibility for your actions or responsibility for the actions of those underneath you cease to matter and integrity becomes non existent.

Through bad and painful personal experiences with my local health trust I will not, if conscious, attend at least 2 hospitals within the trust,in fact I travel to Leeds from Edinburgh for anything that involves invasive treatment for my condition so terrified am I of being treated by certain aspects of my trust, where you are seen as little more than a condition and a tick on some target or other. Should you complain then the NHS will use all and every means to silence or at least discredit you.

Are the NHS hospital service likely to get better or even change, no danger,no matter what politicians have been spouting. The NHS Hospital service is broken, it is now become overly corporate where vast sums are spent on PR consultants, corporate entertainment,flash offices, yet nurses are stretched so thin that it is extremely difficult for them to function in a way that they should.

Fortunately I have a terrific GP practice without whom it is unlikely that I could post this and I am not being melodramatic and 4 years later I am still struggling to get information as my local trust will use every means to delay providing the requested documentation.

Sorry have detoured somewhat from the main thread but I was trying to point out that the Mid Staffs story of poor care is not an isolated incident and that it is incredibly difficult exposing failings as there is a complacency that seems to permeate throughout the hospital service of the NHS.

Over the past five months, following a serious crush injury to a foot, I have spent quite a bit of time at my local NHS trust hospital - both as an in-patient and as a post-operative patient attending the fracture clinic.

I relieved the boredom during my time there by chatting to various members of the medical staff - A Consultant surgeon, doctors and nurses,physiotherapy people, plus the hospital Matron, about their working conditions. It was an ideal opportunity to get a 'horse's mouth' account of what it's like to work inside the system.

Without exception all of these people said the same thing - the people who administer the NHS are completely out of touch with those whose job it is to deliver medical services, and with the customers - the patients who turn up, sick or injured, day in and day out, expecting a high standard of medical care.

One man, a senor plaster technician, told me that he needed a 'right-hand' experienced person to work as a part of his team. After waiting for weeks he was suddenly told that someone would be starting the following Monday. This person had been selected by an administrator who had no medical experience at all, and no idea of the complexities of the work the new person would be doing. The man I spoke to said he was not consulted, not given a chance to meet potential candidates, and had no idea of the chosen person's experience or capabilities. As a result he was irritated, and felt undervalued - he resented the fact that nobody appeared to care what he thought,as long as a vacancy was filled.

Nurses told me that they felt unable to deliver the care that they felt the patients on their ward needed because of staff shortages, and the sheer volume of paperwork they had to complete on every shift. One said she felt like a 'glorified skivvy' and that she felt her years of training had been a waste of time.

Interestingly, not one person mentioned money; all the complaints were about a lack of communication between administrators and medical staff, and the workloads - paperwork was a major gripe, because staff felt it took up too much of their time,and that a lot of it was totally unnecessary.

I received excellent care from everyone I came into contact with, but there was a general sense of them being overworked, and not having enough time to relate to their patients as people.

Who is to blame at Mid Staffordshire? I don't know, it's probably a mix of people, both medical and administrative. What I do know is that any organisation of any size that deals with individuals at the point of delivery has to work hard to stay in touch with those people, and not to fall into the trap of seeing them as statistics. The NHS must obviously be a special case - its customers are vulnerable for one reason or another, and the potential for mistakes is enormous. Medical and nursing staff are there to deliver that care, administrators are there to handle the logistical problems. The two branches of the business must communicate and try to understand each others problems the system is to function smoothly.

I'm convinced that the problems at Mid Staffordshire were largely due to a lack of that essential communication, and a general falling off in standards because of a blind obsession with budget cuts on the part of senior management. Pinning down the culprit(s) in individual cases may prove to be very difficult, if not impossible.

I think the idea of finding someone to blame is a bad one in this case.

The danger is that once the 'guilty parties' have been identified everyone else thinks that the problem is solved.

What the report seems to be saying is that there is no-one at Mid Staffs who can be complacent about their role in the affair.

That means there needs to be a refocus on care throughout the NHS. Many of the examples of poor care given in the Mid Staffs case have happened to my wife at various times. Luckily, they've never occurred all at once.

I do think that morale within the NHS is a pressing issue though, and needs addressing. We need people managing our health services who come from health professions, and understand the unique challenges and demands that come with the profession.

I would suggest that some consultants, junior doctors and other medical staff within the NHS should never have had the opportunity to be in their professions.i have met consultants whose arrogance was astonishing and could not communicate to me the patient.There have been several cases where health professionals have demonstrated neglectful, lazy attitudes in their roles, and it's the patient who suffers. Sure, the mis-management of the NHS is a contributory factor in large scale cases such as this, but those involved must also take some responsibility too. Mis-management is not, and never should be an excuse for laziness, cutting corners or downright neglect.

The fact that a leading light within the management of Mid Staffs during the period in question is now in an NHS chief is not helpful and will do little to inspire confidence given the criticism in the report. Added to this there have been several doctors investigated by the GMC but not a single one found wanting.

In a corporate world, those involved in such a terrible tragedy as this would have lost their jobs long since. It would appear that it is still acceptable to cause death by either using poor processes or practices with lead to low moral, staffing and service but still be rewarded for it within the NHS. Perhaps the charge of Corporate Manslaughter needs amending to encompass such negligence within medical bodies and their management.

Regards blame and replacing one person for another, if it's suspected that certain individuals are to blame, then these individuals should be dealt with in accordance with disciplinary procedures, and the process should be both fair and transparent. Any health care professional who has wilfully neglected their duties should be removed from their profession. There must have been an element of wilful neglect on the part of some of the staff at Mid Staffs.

In the same vein though, those who make working conditions so unnecessarily demanding on health care staff should be made accountable too (politicians, political parties and bureaucrats take note). If we are going to make the NHS great, then we need to separate the chaff from the wheat, remove those who have no place in such an organisation and ensure that those managing the organisation actually understand the work that is done by the NHS. Leave the management of our health care services to those who are experienced in working within these services. Stop fast tracking graduates into management positions, stop bringing management in from the commercial sectors with no NHS experience, and stop making changes without fully understanding or appreciating the implications of those changes!

I am reliably informed that in my local hospital the waste is enormousness and the management staff do not have a clue or indeed seem to be able to control what is going on, very much a case of too many chiefs and not enough Indians.

"Any health care professional who has wilfully neglected their duties should be removed from their profession."

Yes, but therein lies the rub,as they say. Nurses will tell you that they are under-resourced and over-worked; they simply do not have the time to provide every patient with the degree of care that they would wish to.

Doctors will tell you that they work long hours and see many patients - having made a diagnosis or judgement they rely on others to implement treatments and care routines. In addition, many wards are short-staffed, and may have to rely on agency nurses. My ward sister told me that she simply could not get enough nurses with sufficiently high standards to run the ward as she would like to run it.

Trying to pin down a liable individual in such circumstances must be fraught with difficulties - not insoluble difficulties, however, just time consuming.

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